JSFiddle - React, Tailwind, and code Playground

HTML

<table border="1">
  <tr>
    <td colspan="2">amount requested</td>
    <td rowspan="2">info<br />text<br />here</td>
  </tr>
  <tr>
    <td>first name</td>
    <td>last name</td>
  </tr>
  <tr>
    <td>zip code</td>
    <td>city</td>
    <td>state</td>
  </tr>
  <tr>
    <td colspan="2">date of birth</td>
    <td>social security no</td>
  </tr>
</table>